The Reason

The Reason

Little Emily should not have been admitted to our intensive care unit. Why didn’t the EMTs take her to the nearby children’s hospital? I lamented. At eighteen months, she was too old for our hospital’s newborn intensive care, and severe brain damage made her too unstable to transport. So here she was in adult ICU, stuck between an elderly woman with double pneumonia and a man with a fresh cardiac bypass.

Emily’s last prehospital day had dawned cold and clear. After being cooped inside with the recent snow, her mother decided to take her for an outing. She bundled up her little daughter, put her in the stroller, and set out on a walk along their country lane. The bright sun was beginning to warm the air, and Emily delighted in pointing at the snow melting on the side of the road.

Little Emily should not have been admitted to our intensive care unit. Why didn’t the EMTs take her to the nearby children’s hospital? I lamented. At eighteen months, she was too old for our hospital’s newborn intensive care, and severe brain damage made her too unstable to transport. So here she was in adult ICU, stuck between an elderly woman with double pneumonia and a man with a fresh cardiac bypass.

Emily’s last prehospital day had dawned cold and clear. After being cooped inside with the recent snow, her mother decided to take her for an outing. She bundled up her little daughter, put her in the stroller, and set out on a walk along their country lane. The bright sun was beginning to warm the air, and Emily delighted in pointing at the snow melting on the side of the road.

It was the snow that was her undoing. As a car came over the next hill, the sun reflected off the white surface and temporarily blinded the driver. He didn’t see Emily or her mom. His car struck the stroller and sent the baby flying thirty feet where she landed on her head. Her mother was uninjured.

When doctors first examined Emily, her pupils were dilated and fixed. They immediately took her to surgery, but there was little they could do. “Her entire right hemisphere is oatmeal,” one neurosurgeon said. “She’ll never walk or talk again. I doubt she’ll even make it out of the hospital.”

I first saw Emily a week after the accident. Well, at least she’s still with us, I thought as I looked at my beautiful little patient. Her wispy blond hair was replaced by a puffy, red suture line on the right side of her head. The hair might grow back one day, I thought, but nothing will replace the damaged brain cells inside. I did my best to take care of Emily using the pediatric equipment we improvised, but fretted over the hopelessness of her situation.

The immensity of the tragedy became even more clear whenever I saw Emily’s mother. Grief and guilt aged that young woman more than forty years could have. She would stand at her baby’s bedside and pat her little hand, crying bitter tears. It was more than I could bear to watch. Why couldn’t they have taken her to the pediatric hospital? I thought.

Gradually, however, we weaned Emily off the ventilator. Finally, her pulmonary doctor ordered the evening nurse to remove her endotracheal tube. Emily breathed on her own, and her mother rejoiced. Later, on the night shift, I heard mewing sounds from Emily’s room. I thought at first she was trying to cry but soon realized she was “crowing,” a sound caused by strictures in her trachea. Back went the ET tube. I wrapped my arms around Emily’s mother as she cried over this latest injustice.

Two days later, the tube came out for good, but there was still no response, no indication that Emily would ever know anyone or anything. A “vegetable,” that’s what people will call her, I thought. Her mother will be taking care of her until she dies. So sad.

Eventually the doctors deemed Emily stable enough to move to the pediatric floor. At least I would not have to watch as her mother tried in vain to get her to say “Mama” or “wata,” two words she could say before her accident.

Five weeks passed, and I forced myself not to think about Emily. After all, I knew what the outcome of her situation would be.

One night, a pediatric nurse visited the ICU and announced, “Emily’s going home tomorrow.”

Good, I thought, at least her mother can take her home and care for her forever.

“Not only that, but she’s reaching for her mother, calling her ‘Mama,’ and asking for ‘wata’!”

The next day, as they prepared to leave, Emily walked across the room into her mother’s arms.

It was then I knew the reason Emily had come to our adult intensive care unit.

She came to show me that we must never give up, no matter how grave the situation seems, or how many experts tell us the outcome is futile.